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Appendix 114Pertussis Surveillance Worksheet HEADDRESS (Street and No.) (last) (first)Phone Hospital Record No. This information will not be sent to REPORTING SOURCE TYPE NAME physician PH clinic
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How to fill out pertussis surveillance worksheet- appendix
How to fill out pertussis surveillance worksheet- appendix
01
To fill out the pertussis surveillance worksheet- appendix, follow these steps:
02
Gather the necessary information such as patient details, date of onset of symptoms, and date of diagnosis.
03
Start by filling out the basic demographics of the patient, including their name, age, gender, and contact information.
04
Move on to the clinical information section and provide details about the symptoms presented by the patient, such as cough type, duration, and severity.
05
Provide information about the laboratory tests conducted on the patient, including the type of test, results, and the laboratory where it was carried out.
06
If applicable, fill out the immunization history of the patient, including the dates and types of pertussis vaccinations received.
07
Finally, complete the remaining sections of the worksheet, including the patient's medical history, hospitalization details, and follow-up information.
08
Review the filled-out worksheet for accuracy and completeness before submitting it for further processing or analysis.
Who needs pertussis surveillance worksheet- appendix?
01
The pertussis surveillance worksheet- appendix is typically needed by healthcare professionals and organizations responsible for monitoring and tracking cases of pertussis (whooping cough).
02
This includes public health departments, medical practitioners, hospitals, clinics, and laboratories involved in the surveillance and reporting of infectious diseases.
03
The worksheet serves as a standardized tool to collect and record essential information about pertussis cases, which is vital for disease surveillance, monitoring outbreaks, and implementing appropriate control measures.
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What is pertussis surveillance worksheet- appendix?
It is a document used for tracking and reporting cases of pertussis (whooping cough) in a specific area.
Who is required to file pertussis surveillance worksheet- appendix?
Healthcare providers, laboratories, and public health departments are required to file the worksheet.
How to fill out pertussis surveillance worksheet- appendix?
The worksheet should be filled out with relevant information such as patient demographics, symptoms, diagnosis, and treatment.
What is the purpose of pertussis surveillance worksheet- appendix?
The purpose is to monitor and control the spread of pertussis by providing data on cases for analysis and intervention.
What information must be reported on pertussis surveillance worksheet- appendix?
Information such as patient demographics, symptoms, diagnosis, treatment, and contact information must be reported.
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